Dear Mr Matt Hancock, Mr Simon Stevens, Mr Elliott Howard-Jones and local West Herts MPs,

It has been described as a “milestone” but in reality it is only just another tick in the box for West Herts Hospitals Trust in their quest to plough hundreds of millions of pounds into redeveloping Watford General Hospital (WGH), and to a far lesser degree St Albans City and Hemel Hempstead hospitals.

Even after £350 million has been spent on the current sites, West Herts would still have an A&E hospital on the outskirts of the community it serves, right next door to a Premier League football ground, poorly served by public transport, not connected to the county’s motorways and main roads, on a extremely sharp gradient and still in need of significant investment to maintain and replace the buildings.

Just as worrying is that after the trust has ploughed £298 million into Watford General Hospital, West Herts’ only A&E hospital will probably not have the capacity or functionality to be able to cope with the soaring population growth expected in West Herts during the next 15 years!

To add to this - after spending £52 million on both St Albans City and Hemel Hempstead hospitals, both former A&E hospitals will still require significant and further investment over the next 10-15 years or risk being scaled back further or even closed. In my opinion, should the Trust’s redevelopment plans go-ahead, there is a real possibility that West Herts will end up with a single site hospital at Vicarage Road.

Why don’t the trust and Herts Valleys CCG admit that the building of a new purpose-built A&E hospital from scratch on an unoccupied clear site has to be more affordable, more efficient and less disruptive than trying to rejig, modernise and expand West Herts’ current three dilapidated hospitals?

Common sense also tells you that a more central West Herts A&E hospital would not only be fairer to the majority of those needing emergency treatment but also would make life easier for the ambulance service to coordinate its vehicles and staff within West Herts. - very important in getting to a seriously ill patient and then taking them to an acute services hospital! Ambulance staff shouldn’t have to wait at an A&E hospital to hand their patients over due to capacity issues. A new hospital can be designed to overcome this issue.

The trust and CCG have tried to counter the arguments raised by campaigners for a new A&E hospital in a more central West Herts location by simply saying that a new hospital is not affordable, a new hospital would upset patient inflows for other nearby Trust’s hospitals and there would be excessive costs to move essential services from WGH to a new location. The Trust also say that West Herts’ needs are unique and campaigners shouldn’t compare their redevelopment plans with what is going on in other parts of the UK - Really! Why did the trust cost a new hospital at over £1 billion in 2017 and then drastically reduce this cost to between £700-750 million earlier this year? How can anyone have confidence in the Trust’s calculations for a new hospital after this?

Apart from Sir Mike Penning all other local politicians have either backed the trust’s plans or conveniently sat on the fence.

Watford’s Conservative MP Richard Harrington is quoted as saying: “I have been pushing for redevelopment of the hospital for a long time. I will of course support these proposals. I have had meetings in the past with Matt Hancock MP, Secretary of State for Health, and Lord Prior, chairman of NHS England, and I hope to meet them again soon.”

Mr Harrington, I was of the understanding that the local CCG and trust were responsible for West Herts hospital planning so why are you lobbying central government? Why should Mr Hancock only listen to you as Watford’s MP on such an important matter affecting the whole of West Herts? If you are going to have meetings with senior government ministers about West Herts’ hospitals please involve all West Herts MPs in these meetings.

Far from being the end of the campaign for a new West Herts A&E hospital, this is where it all gets very interesting as the trust will now submit their SOC to the Hertfordshire and West Essex Sustainability and Transformation Partnership. Yes, the same STP that includes the Princess Alexandra Hospital NHS Trust who unlike WHHT are pursuing plans for a brand new “state of the art” A&E hospital. Should the STP approve West Herts’ plans they will then be submitted to the NHS regulators for an independent and thorough review. (Hopefully new hospital campaigners arguments for a new A&E Hospital have not fallen on deaf ears!) The Trust plans will also require approval for funding as part of the Government’s autumn spending plans. If the Trust are successful with their SOC and funding, they will then need to prepare a detailed and costed outline business case for submission to the NHS regulators. As part of the OBC architects, structural engineers and surveyors will be engaged to work on assessing WHHT’s hospital buildings that are due for refurbishment. it will then become much clearer whether some of the buildings that are due for refurbishment are actually in a much poorer state than expected and need far more invasive and costly structural work to be undertaken to meet the required building standards and regulations.

Should the trust have its case approved and the redevelopment goes ahead, it will be under pressure to deliver all it has promised - without major disruption, within budget, on-time, resembling close to the computer generated images of a redeveloped hospital that the trust released and without major incident(s).

Hopefully the new Prime Minister, the Secretary of State for Health and Social Care and the NHS regulators will see sense and request that the trust revisit their evaluation process and transparently evaluate the new hospital options.

It is important to remember that once £350 million has been spent on redeveloping the trust’s current hospital estate the opportunity will surely be lost for generations to come to get what West Herts really needs now and in the longer term - a new, purpose built and more central “state of the art” A&E hospital.

This is the time for Boris Johnson and Matt Hancock to stamp their vision on the NHS and make sure that not only do communities have fairer access to their A&E hospitals but that NHS Trusts achieve real value for money and invest tax payers in new hospitals rather than the overly expensive and disruptive redevelopment of occupied dilapidated estates.

Andrew Love

St Albans